C反应蛋白/白蛋白比值在急性胰腺炎并发器官功能衰竭中的诊断价值

Diagnostic Value of C-reactive Protein/Albumin Ratio in Patients with Acute Pancreatitis Complicated with Organ Failure

目的评价C反应蛋白(CRP)/白蛋白(AB)比值对急性胰腺炎(AP)并发器官功能衰竭的诊断价值。方法选取2016年1月-2018年1月我院收治的AP患者200例,根据是否合并器官功能衰竭分为未发组(n=102)和衰竭组(n=98),检测所有患者CRP、AB并计算其比值,分析CRP、AB及其比值与器官功能衰竭的关系。结果衰竭组急性生理和慢性健康评分Ⅱ(APACHEⅡ)、序贯器官衰竭评估量表(SOFA)、CRP、CRP/AB比值(补充这个)明显高于未发组,衰竭组AB明显低于未发组,差异有统计学意义(P <0. 05);ROC曲线结果显示,在评估AP发生器官功能衰竭的敏感度、特异度、准确度方面,CRP以0. 24 mg/L为临界值时分别为78. 43%,80. 61%,79. 50%,AB以55. 64 mg/L为临界值时分别为83. 33%,79. 59%,81. 50%,CRP/AB比值以0. 27为临界值时分别为93. 14%,91. 84%,92. 50%,CRP/AB比值明显高于CRP、AB,差异有统计学意义(P <0. 05)。结论 CRP、AB水平变化与AP患者器官功能衰竭的发生有关,检测其水平可作为评估AP发生器官功能衰竭的重要指标,且CRP/AB比值具有更佳的效能,值得临床作进一步推广。

Objective To evaluate the diagnostic value of C-reactive protein( CRP)/albumin( AB) ratio for acute pancreatitis( AP) complicated with organ failure. Methods A total of 200 AP patients admitted to our hospital from January2016 to January 2018 were divided according to whether they were complicated with organ failure into two groups: the uncomplicated group( n = 102) and the failure group( n = 98). Their CRP and AB were tested and their ratio was calculated to analyze the relationship between CRP,AB and its ratio,and organ failure. Results The acute physiology and chronic health scores II( APACHE II),sequential organ failure assessment scale( SOFA),CRP,and CRP/AB ratios( supplemented)were significantly higher in the failure group than in the uncomplicated group. The difference was statistically significant( P <0. 05). The Results of ROC curve showed that the sensitivity,specificity and accuracy of organ failure in evaluating AP were 0. 04 mg/L,which was 78. 43%,80. 61%,79. 50%,when AB is 55. 64 mg/L,the critical value is 83. 33%,79. 59%,81. 50%,and the CRP/AB ratio is 0. 27%,91. 84%,92. 50%,respectively. The CRP/AB ratio was significantly higher than CRP and AB,and the difference was statistically significant( P < 0. 05). Conclusion The changes of CRP and AB levels are related to the occurrence of organ failure in AP patients. The detection of these levels can be used as an important index to evaluate organ failure in AP,and the CRP/AB ratio has better efficacy,which is worthy of further clinical promotion.